I hope this is the correct place to post this question. My alert, vibrant 83 year old grandma broke her femur early Saturday morning. She had surgery Sunday morning and seemed to be doing fine, all things considered. Today, Monday, the minute I walked into the room, I knew my grandma was different. She had a "wild" look to her eye. She recognized everyone but seemed to be confused about where she was. She thought she was back in her apartment smoking cigarettes (her 60 year + habit). She was trying to get out of bed to grab cigarettes she thought she saw on the wall. I could go on and on but you get the picture....she looked like she was in the stages of early dementia.

My grandma's leg is progressing normally. She's been on morphine but I think they switched her to vicadan (sorry, don't know how to spell). She also is on some anxiety medication as she was before the fall. In addition, she was given a nicotine patch today to help with the withdrawal. Her sodium is low for some reason and she might have to have a blood transfusion tomorrow. In addition, her oxygen levels weren't where they should be. With all this and my grandma's overnight transformation from alert to halucinatory, is this permanent? This happened literally overnight. It's so difficult to get information from the doctors and nurses. They can't say anything for sure. My grandma lived on her own before this. If she continues as she is, I can see her bedridden in a full-blown nursing home situation.

Any information about similar experiences you have dealt with would be very helpful. This is such a stressful situation right now not to mention dealing with insurance (or lack thereof) for rehab and nursing home facilities in the future.

It doesn't have to be permanent. Maybe it's only a reaction to the very strong pain meds. Your Grandma may be just fine after a couple of weeks of recovery. Many elderly people show such confusion after surgery.

My Mom (97) broke her femur in September. She had an operation to repair it and was healing well, but when I saw her in mid October (at a rehab center) she was in horrible shape. She could not find her nose to wipe it when it was runny. She couldn't find her glasses as they slipped down her nose. I thought her whole nervous system was out of whack.

Mom had already had dementia for a couple of years, and we thought this was now the final stage, hurried on by the fall, operation, and meds.

A week or so later they took her off the strong pain killers and gave her only Tylenol. The good news is that her hand/eye coordination improved totally, she can now pick up her fork and eat normally - whereas in October she had to be fed. She also had some problem with her swallowing reflex and had to be fed only liquids. That has improved to the extent that she now eats all kinds of normal food.

Mom had to stay at the nursing home. She was never able to learn to walk again, even with a walker ..it was just too hard, too much effort, and her Dementia caused her not to see the connection between going through painful therapy and getting physically stronger and going home.

She is however quite happy at the NH. and she is almost 15 years older than your grandma.

Since your grandma had no signs of Dementia before the accident, I think she has a good chance of full recovery. Therapy will be hard work, but if she has the motivation to do it, she will succeed. And try to get them to take her off that Vicodon (I don't know the spelling either) so she gets her lucidity back! My son in law was in his 20s when he had to be on morphine after a burst appendix - he saw things crawling up the walls ... that was the morphine.

Jenny,
My FIL was 87 when he had surgery for an abdominal aortic aneurysm. Like your grandma he lived on his own before surgery. After surgery, he was so doped up that he couldn't hardly keep his eyes open, definitely couldn't walk, he was hallucinating, and they were talking like they thought he would need to go to full nursing care. I explained to everyone who would listen that he had been ON HIS OWN prior to this, this was NOT HIM, and they had to get him off of the meds that were doing this to him. I felt like the nurses were liberally using the "as needed" medication orders for meds that would keep him from bugging them too much. (I think they wanted him to be doped up so he would be fine with laying in his own waste...) The doctors listened to me and discontinued the various med orders (like Ativan, etc.) and he started to come out of it within 48 hours and he did get back to the same level as before surgery. During this time, I stayed at his bedside round the clock to do the best I could to take care of his needs, keep him from pulling out his IV's and keep the nurses with needles/meds away! Although he had been on his own prior to this, he really was ready for assisted living - so we made that transition after the surgery (hospital to rehab to assisted living).

Talk to the docs and make sure they understand what her functioning was like before this and try to get them to discontinue any non-essential meds that might be causing the problems. Good luck.

This also happened to my mother. She saw spiders on the wall, thought she was in a room that also had motorcycles in there. She asked us to turn off the Xmas lights on the wall. I got scared, but found out it was the pain medication. Watch the tranquilizers too like they have said, they can really put them in a lot of confusion. Husband has dementia and they gave them to him and he got more confused. Talk to doctor about your concerns and see if they can try something else. I am sure she will come back to baseline, my mom did. Than Goodness.
Diane

Everytime my dad has had a procedure or an operation, he has gone down hill, to some extent. Sometimes, he does come back up a little, but some times, he is halfway to the next level and stays there!

Pain pill, valium, IVs, anything sort of shocking or really confusing or different affects him greatly!!!!! I think they just give too much to older people and do not realize that it affects them 2 times as much as younger or middle age people!

Some friends think that my dad started with his alzheimers problems, as long as 12 years ago (just slightly). That is when my sister died unexpectedly. Then some people, like me, think that it started when he had prostate cancer, about 6 - 7 years ago. Just had to go thru radiation, no operation. And since then, he has had 2 eye operations (out patient, but with drugs), 1 hernia operation (same), and 1 urology procedure. I will not let him have any other operations or procedures. It is just not worth it. Just makes him go to the next level.

I also think that my dad has had some mini strokes that went undetected. He is now in a good time, not going down, just staying the same and not irate at all. He may be a little depressed, tho.

Now, my mom is a totally other case!!!!! I do not anyone could figure out how she got dementia!!!!! The granddaughters have called her "bonkers" (in private) for at least 10 - 15 years! :>

Pain pill, valium, IVs, anything sort of shocking or really confusing or different affects him greatly!!!!! I think they just give too much to older people and do not realize that it affects them 2 times as much as younger or middle age people!

Until their daughter/sister stepped in and said something. My dad always seems to be "different" after surgery - he's 87 - and I believe they do tend to over medicate - They don't want ANYONE to complain about pain. He has some dementia so it gets even worse when this happens.

EVERY time a nurse came in to see me in the hospital, the first thing they asked was how much pain I had. They were very willing to give me pain meds!

My Dad had this too. A lot of the strange things he said seemed to be attempts to make sense of where he was and what was going on. I thought about it from his standpoint, he was in an unfamiliar room, and all these unfamiliar people were coming in every 15 minutes doing something to him. The room may as well have been a sensory deprevation tank - white walls, white curtains, there wasn't much for him to do, most of the time he couldn't see out the window and he didn't care about TV. I'd get a little bonkers in those circumstances myself.
It took a week or so for him to settle back down once he got back to the nursing home. The staff there just expected it when their residents would go to the hospital.

My grandma is now in a rehab facility. She seemed herself when I visited yesterday but then, last night, she had another "confused" episode. She is in a fancy rehab facility where she can only stay a maximum of 20 days due to her insurance. We all felt better knowing that she had 20 days there until the facility told us she would be evaluated every 3 days. If she is determined to be not progressing, she will be released from care. My family is not rich--my grandma will have to go on Medicaid (as many do I know) and move to a nursing home. It's frustrating, painful, disappointing, etc. to compare a "medicaid" nursing home to the "non-medicaid" home. The facility she is in now has wide carpeted halls, fish tanks, murals on the wall, etc. I guess when you are poor, you don't deserve that. Of course, I am being sarcastic here. I just feel that the elderly are not treated as well as they should be in the country and perhaps everywhere. I'm sure I'm preaching to the choir!

The three day evaluation is especially worrisome if my grandma continues to be confused. In her confused state, she is completely not herself and unwilling to make progress with rehab. So, she could be released in 3 days. I worry about my mother so much as she is taking the brunt of all of this. I am trying to help as much as possible to relieve some of her stress but there is only so much I can really do. If my grandma is released, she will have to live with my mom and dad until a nursing home can be secured. My parents are older so this will definitely take a toll.

Thanks for the replies here because I know this board is really for those with loved ones with alzheimers or dementia which my grandmother doesn't have at least yet. I have seen what dementia and alzheimers can do through my grandpa and uncle. It is awful and I feel for all of you going through something so terrible.

I will let you know how things go. When I visited my grandma yesterday, I recognized her again. But, it was like the lights were out in her eyes. It's like, for the first time, I really recognized that she is 83 years old. For the first time it has hit me that I won't have her forever. It kills me but I have to remember that I am so lucky to have had the time I have had with her.

God bless you all and I wish the best for each of you in your situations.

The nursing home situation is what we are going thorugh with Mom. She fell, broke a hip, had rehabiltiation with frequent assessments, and was told 'she is not meeting her goals.' She was removed from Rehab, and eventually (it took a month because of lack of space) moved to a bare empty room without even a phone jack.

She is at the moment paying out of her dwindling savings, but they know she is on a list to get onto Medicaid. Wheter or not this had anything to do with the harsh atomosphere I don't know. But my brother fixed up her room so it is now a cheerful place to be. Mom is much older than your Grandma, at 97, and there was the added problem of Dementia. It was not even possible for her to know that she was supposed to meet goals, never mind doing it.

Anyway, when all is said and done, I think she will get into Medicaid, after much difficulty - and will continue to live and be fed, warm, get her meds, be bathed and hair combed etc for as long as she continues to live. Going home was not really an option as all of her children are now 60 or older ... all have various health problems making lifting an invalid not very workable ...

I hope your Grandma does meet the goals and stay there until she is fully rehabilitated, and can then go home again at least for a few years. Good luck!

Thanks for the reply Martha. My parents are over 60..my mom 65, my dad 71, and my uncle 64. So, we are also not able to care for my grandma at home either. None of them can lift her and I can't be around since I have to work. My mother is worried about the possibility of my grandma living with her while waiting for medicaid, a spot in a nursing home, etc. We are potentially in a similiar situation. Insurance is such a tangled web. Fortunately, my grandfather was a mason. There is a wonderful masonic home locally that my grandmother will be able to go to. They will accept her insurance and care for her. However, she will be on a waiting list until an open spot is available. I guess this is true everywhere!

I am so worried about my mother more than anything. I want to support her as much as possilble and stay strong for her too. I don't want her to have to worry about me too...I have to remember this everytime I feel like crying when my mother is around.

My grandma just had a good report on her rehab this morning so I'm hoping we are off to a positive start. She is just so depressed. I guess this is normal but it's not helping her at all.

Glad for the update on your grandmother and I hope she can stay where she's well cared for as she waits for a place at the Masonic Home.

It's quite normal for the elderly to become more confused in the evenings and at night. That's a known fact and it's because because they're tired and all is unfamiliar. The staff at the facility ought to take that into consideration in their evaluation.

(((((hugs))))) I know how difficult it is to face losing someone you love so much, and to see that the lights in your grandmother's eyes have dimmed. I know that so well as my mother had AD when she was just a bit older than your grandmother is. You are wise to remember the good years and all you and she have shared.